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10/25/07 | 70 views | #20070250170 | Prev - Next | USPTO Class 623 | About this Page  623 rss/xml feed  monitor keywords

Disc prosthesis having remote flexion/extension center of rotation

USPTO Application #: 20070250170
Title: Disc prosthesis having remote flexion/extension center of rotation
Abstract: An intervertebral disc prosthesis comprises a first endplate, a second endplate, and a bearing surface positioned between the first endplate and the second endplate. The bearing surface may be provided by a mobile bearing disc including a convex bearing surface configured to engage the first endplate and a concave bearing surface configured to engage the second endplate. The multiple bearing surfaces of the mobile bearing disc engage articulating surfaces on the endplates to form a plurality of articulating joints. Each articulating joint is configured to facilitate a particular type of movement for the segmental unit. Furthermore, each articulating joint is defined by a distinct center of rotation. The contact pair formed by the convex bearing surface of the bearing component and the concave bearing surface of the first endplate may provide a flexion/extension center of rotation for the prosthesis. The contact pair formed by the convex bearing surface of the bearing component and the concave bearing surface of the first endplate may provide a lateral bending/torsional center of rotation for the prosthesis. (end of abstract)
Agent: Maginot, Moore & Beck, LLP Chase Tower - Indianapolis, IN, US
Inventors: Missoum Moumene, Martin Masson
USPTO Applicaton #: 20070250170 - Class: 623017150 (USPTO)
Related Patent Categories: Prosthesis (i.e., Artificial Body Members), Parts Thereof, Or Aids And Accessories Therefor, Implantable Prosthesis, Bone, Spine Bone, Having Opposed Bone-plates Which Moves Relative To One Another
The Patent Description & Claims data below is from USPTO Patent Application 20070250170.
Brief Patent Description - Full Patent Description - Patent Application Claims  monitor keywords

BACKGROUND

[0001] This invention relates to the field of prosthetics, and more particularly, to an intervertebral disc prosthesis designed to replace a damaged intervertebral disc.

[0002] The human spine consists of twenty-four small bones known as vertebrae that protect the spinal cord and provide stability to the torso. The vertebrae are arranged in a column and stacked vertically upon each other. Each vertebra is comprised of two parts including an anterior part and a posterior part. The anterior part is often referred to as the vertebral body, and the posterior part is often referred to as the vertebral arch. The vertebral bodies are generally separated by a fibrous bundle of tissue called an intervertebral disc. These intervertebral discs act as a cushion to the spinal column by absorbing energy and transmitting loads associated with everyday movement. They also prevent the vertebrae from rubbing against each other. The combination of an intervertebral disc and its associated superior vertebra and inferior vertebra may be referred to as a functional segmental unit.

[0003] Over time, the normal aging process causes the intervertebral discs to degenerate, diminishing their water content and thereby reducing their ability to properly absorb the impact associated with spinal movements. Diminished water content in the intervertebral discs may also cause the vertebrae to move closer together. Tears and scar tissue can weaken the discs, resulting in injury. When the discs wear out or are otherwise injured, a condition known as degenerative disc disease results. With this condition, discs do not function normally and may cause pain and limit activity.

[0004] The condition of degenerative disc disease can potentially be relieved by a surgical procedure called artificial disc replacement or total disc replacement. In this procedure, the damaged intervertebral disc is replaced by an intervertebral prosthetic device (i.e., an "artificial disc" or "intervertebral disc prosthesis"). A typical prior art artificial disc comprises two endplates. One endplate faces a superior vertebra and the other endplate faces an inferior vertebra. A bearing surface is provided between the two endplates, allowing the endplates to rotate relative to one another and generally mimic the motion allowed by a natural disc.

[0005] In order to be safe and efficacious, a total disc replacement should not disrupt the normal kinematics of the functional segmental unit. Preferably, an intervertebral disc prosthesis should allow the vertebra to move with respect each other by means of the same, normal, physiological, instantaneous centers of rotation as the intact functional segmental unit. Under normal conditions a superior vertebra and inferior vertebra for a given functional segmental unit will rotate with respect to each other about differing centers of rotation, depending upon the type of movement, whether flexion/extension, lateral bending, or axial rotation (also sometimes called as "torsional rotation"). Therefore, the center of rotation that defines one type of movement may be different from the center of rotation that defines another type of movement.

[0006] As noted above, the locations of instantaneous centers of rotation in the lower cervical spine depend on the type of forces exerted on the spinal segments. While the locations of these instantaneous centers of rotation have not been precisely pinpointed, general observations have been made. For example, with respect to the C5-C6 cervical functional unit, axial rotation appears to be defined by a center of rotation (COR) that is located within the disc space when viewed from above but either to the left or to the right of the geometric center of the disc, depending on the direction of motion. For flexion/extension (F/E) movement, the COR at C5-C6 is located at the anterior portion of the subsequent, lower vertebra. In lateral bending, there is much speculation about the region of interest for determining the instantaneous centers of rotation. However, it appears that lateral bending is defined by a COR near the geometric center of the disc, which varies depending on the direction of motion.

[0007] Contemporary cervical intervertebral prosthetic devices typically have a COR that is centrally located immediately below a single contacting surface radius. While this may allow relatively normal lateral bending and axial rotation, such a design does not take into account the normal flexion-extension COR located at the anterior portion of the subsequent, lower vertebra. As far as flexion-extension is concerned, a central COR is not consistent with the normal kinematics of the functional segmental unit. Accordingly, a central COR for flexion/extension movements will force the vertebrae along non-physiologic paths.

[0008] As a vertebra goes through its ranges of motion, the pattern of motion is determined by a combination of the physical contact between the geometric anatomy of the structures, their physical properties, and the properties of the passive restraints that hold the functional units together (ligaments, muscles, etc.). The facets are the anatomical features that contribute most to dictating where the center of motion will be located. In the C5-C6 region, the facets are positioned approximately at a 45 degree angle to the disc. This is an important clue as to an anterior location for the flexion/extension COR. Thus, the centrally located COR typically found in current prosthetic discs is inconsistent with the plane of the contacting facets at the C5-C6 level.

[0009] Accordingly, it would be advantageous to provide a total disc replacement that performs consistent with the normal kinematics of the functional segmental unit. Furthermore, it would be advantageous to provide an intervertebral disc prosthesis configured to provide multiple, adaptative centers of rotation, depending upon the type of vertebral movement facilitated by the disc, including one center of rotation substantially removed from another center of rotation.

SUMMARY

[0010] An intervertebral disc prosthesis having a plurality of independent centers of rotation is disclosed herein. One of the centers of rotation is a flexion/extension center of rotation that is remote from another center of rotation. The intervertebral disc prosthesis is configured for insertion between a superior vertebral body and an inferior vertebral body in a patient.

[0011] The intervertebral disc prosthesis comprises a first endplate, such as a superior endplate, including a first vertebra facing surface and a concave articulating surface. The intervertebral disc prosthesis also comprises a second endplate, such as an inferior endplate, including a second vertebra facing surface and a convex articulating surface. A mobile bearing disc is positioned between the first endplate and the second endplate. The mobile bearing disc includes a convex bearing surface configured to engage the concave articulating surface of the first endplate and a concave bearing surface configured to engage the convex articulating surface of the second endplate.

[0012] The multiple bearing surfaces of the mobile bearing disc engage the articulating surfaces of the endplates to form a plurality of articulating joints (also referred to as "contact pairs"). Each articulating joint is configured to facilitate a particular type of movement for the segmental unit. Furthermore, each articulating joint is defined by a distinct center of rotation. In one embodiment, the contact pair formed by the concave bearing surface of the bearing component and the convex bearing surface of the second endplate is configured to provide a flexion/extension center of rotation for the prosthesis. This flexion/extension center of rotation may be located on an anterior portion of the inferior vertebra. In one embodiment, the flexion/extension center of rotation is located outside of the space directly beneath the concave bearing surface of the bearing component.

[0013] While the contact pair formed by the concave bearing surface of the bearing component and the convex bearing surface of the second endplate is configured to provide a flexion/extension center of rotation, the contact pair formed by the convex bearing surface of the bearing component and the concave bearing surface of the first endplate is configured to provide a lateral bending/torsional center of rotation for the prosthesis. In one embodiment, the lateral bending/torsional center of rotation is located directly below the convex bearing surface.

[0014] In yet another embodiment, the intervertebral disc prosthesis comprises a rail protruding and extending longitudinally across the mid section of the convex articulating surface of the inferior endplate. A mating groove for the rail is provided on the conave bearing surface of the bearing component. The rail is configured to engage the groove when the concave bearing surface of the bearing component is positioned on the convex articulating surface of the inferior endplate. In this fashion the rail and groove of this particular contact pair are configured to facilitate only flexion/extension movements. Lateral bending and axial rotation movements are prohibited by the articulating joint that include the rail and groove, and lateral bending and axial rotation movements must be facilitated by the other articulating joint. In an alternative embodiment, the rail may protrude and extend longitudinally across the mid-section of the conave bearing surface of the bearing component while a mating groove for the rail is provided along the mid-section of the convex articulating surface of the inferior endplate, thus facilitating lateral bending movements.

DESCRIPTION OF THE DRAWINGS

[0015] FIG. 1 shows a side perspective view of an intervertebral disc prosthesis having a remote flexion/extension center of rotation;

[0016] FIG. 2 shows a side cross-sectional view of the disc prosthesis of FIG. 1;

[0017] FIG. 3 shows a lower perspective view of a superior plate and mobile bearing of the disc prosthesis of FIG. 1 positioned along a central axis;

[0018] FIG. 4 shows an upper perspective view of an inferior plate relative to the central axis of FIG. 3;

[0019] FIG. 5 shows an upper perspective view of the mobile bearing of FIG. 3;

[0020] FIG. 6 shows a top view of the mobile bearing of FIG. 5;

[0021] FIG. 7 shows a lower perspective view of the mobile bearing of FIG. 5;

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Joint arthroplasty devices formed in situ
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Expandable intervertebral devices and methods of use
Industry Class:
Prosthesis (i.e., artificial body members), parts thereof, or aids and accessories therefor

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